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Archive January 2017 XVIII, No. 1

Should You Go All In On Laser Cataracts?

The true cost of adding laser-assisted cataract surgery.

Daniel Cook

Daniel Cook, Editor-in-Chief


laser cataract VOLUME CONTROL The ASC of Western New York considered outsourcing its laser cataract service, but had enough cases to support investing in its own platform.

Does it make good business sense to add femtosecond laser-assisted cataract surgery? The answer isn't as clear-cut as the incision a bladeless, computer-controlled laser makes. Some surgeons are hesitant to invest in a six-figure femto laser because reimbursement from Medicare and private health insurance is paltry and the laser hasn't proven to deliver appreciably better results than traditional cataract surgery. Others, however, have found they can quickly pay off the machine they bought outright because their patients don't blink when they tell them it's a few hundred dollars extra per eye out of pocket for a laser-assisted procedure. Then there's the option of partnering with an outsourcing firm that will provide the laser on an as-needed basis, an option that might be best if you host a few cases each month. Before deciding what's best for your facility, consider the true costs of adding the technology, your surgical volume and the number of patients your eye docs can upgrade to laser-assisted surgery.

A numbers game
Patients view the femto laser as a sexy new technology that they want their physicians to use, even if laser-assisted cataract surgery hasn't yet proven to be more clinically effective than manual techniques, even though it is generally more predictable and precise.

"The marketing advantage is real — lasers do attract patients to a surgery center," says Kevin Corcoran, COE, CPC, CPMA, FNAO, president of the Corcoran Consulting Group in San Bernardino, Calif.

The capital investment for a laser is significant — between $300,000 and $600,000 — and you also have to consider the approximately $300 per-case patient interface fee, annual maintenance contacts that run between $25,000 and $50,000, and the staffing costs of the technician who runs the platform. Getting a return on the investment is dependent on having physician-owners recoup the purchase as part of the amount they charge patients out of pocket for premium IOLs and better refractive outcomes.

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